People who receive higher disability ratings for work-related back injuries don’t necessarily fare worse over the long term than those who get lower ratings, a Saint Louis University study finds.
The study, which reinforced previous research showing blacks receive less treatment for their back pain than whites, was published online this month in the Journal of Pain. The new research is among the first to examine the relationship between workers’ compensation settlements for back pain and long-term functional outcomes.
“A disability rating is supposed to reflect the amount of impairment a person has at the time that a case is closed. The presumption is that levels of impairment are stable and related to day-to-day levels of function. I was shocked that the associations between disability rating and subsequent levels of function weren’t stronger,” said Raymond Tait, Ph.D., professor of psychiatry at Saint Louis University School of Medicine.
Disability ratings also differed between African-Americans and Caucasians. According to Tait, those differences probably reflected differences in treatment: whites were four times more likely to have surgery than blacks. Those who had surgery received larger settlements for their injuries, Tait said.
“While surgery inflated disability ratings, there appeared not relationship between surgery outcomes and how a person did thereafter,” he said.
Tait and colleague John Chibnall, Ph.D., also a professor of psychiatry at Saint Lois University, looked at about 1,500 Missouri workers – 580 African-Americans and 892 Caucasians – whose Workers’ Compensation claims for lower back pain were settled between Jan. 1, 2001 and June 1, 2002.
Researchers interviewed the employees 21 months after their settlements about how they were doing. They asked questions about pain intensity, general physical and mental health and whether they currently were working.
Tait and Chibnall said that their findings “raise questions about both the validity and the fairness of the current disability determination program. Disability settlements are designed to give people money toward a fresh start. Those settlements do not appear to reflect the residual levels of disability that people actually experience.”
Saint Louis University School of Medicine
Journal of Pain
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